Health Insurance FAQ

Below are some frequently asked questions about health insurance!

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1. What is health insurance? Health insurance is a type of insurance that helps cover the costs of medical and surgical expenses. It typically involves paying a monthly premium to an insurance company, which then provides coverage for a variety of medical services.

2. Why is health insurance important? Health insurance is important because medical care can be very expensive, and it can help protect individuals and families from the financial burden of unexpected medical bills. It can also help ensure that people have access to the medical care they need to stay healthy.

3. What types of health insurance are there? There are several types of health insurance, including:

   • ​HMO (Health Maintenance Organization)

   • PPO (Preferred Provider Organization)

   • ​POS (Point of Service)

   • EPO (Exclusive Provider Organization)

   • High-deductible health plans (HDHPs)

4. What is a premium? A premium is the amount of money you pay each month for your health insurance coverage. The amount of the premium will depend on several factors, including your age, health status, and the type of plan you choose.

5. What is a deductible? A deductible is the amount of money you must pay out of pocket for medical expenses before your health insurance coverage kicks in. For example, if you have a $1,000 deductible and you incur $2,000 in medical expenses, you would be responsible for paying the first $1,000 and your insurance would cover the remaining $1,000.

6. What is a copay? A copay is a fixed amount of money that you pay for a medical service, such as a doctor's visit or a prescription drug. The amount of the copay will depend on your health insurance plan.

7. What is coinsurance? Coinsurance is the percentage of the cost of a medical service that you are responsible for paying after your deductible has been met. For example, if your coinsurance is 20% and your medical bill is $1,000, you would be responsible for paying $200 (20% of $1,000) and your insurance would cover the remaining $800.

8. What is a network? A network is a group of healthcare providers, such as doctors, hospitals, and clinics, that have agreed to provide services to patients who are covered by a particular health insurance plan. If you go to a provider that is outside of your network, you may be responsible for paying more out of pocket.

9. What is an out-of-pocket maximum? An out-of-pocket maximum is the most you will have to pay for covered medical expenses in a given year. Once you reach this amount, your health insurance will cover all remaining costs for covered services. The out-of-pocket maximum will vary depending on your health insurance plan.

10. What is a pre-existing condition? A pre-existing condition is a health condition that you had before you enrolled in a particular health insurance plan. Prior to the Affordable Care Act (ACA), insurance companies could deny coverage or charge higher premiums to people with pre-existing conditions. However, under the ACA, insurance companies are required to cover pre-existing conditions at no additional cost.